Validation of Heart Failure-Specific Risk Equations in 1.3 Million Israeli Adults and Usefulness of Combining...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Rising global heart failure (HF) prevalence necessitates effective prevention strategies.
• Current HF risk prediction models often lack validation in diverse, real-world populations outside the US.
• Accurate risk assessment is crucial for targeted HF prevention interventions.

Purpose of the Study:

• To externally validate the performance of the Pooled Cohort Equations to Prevent Heart Failure (PCP-HF) for 5- and 10-year risk prediction.
• To assess the PCP-HF model's accuracy in a large, contemporary Israeli cohort using electronic health records.
• To evaluate the utility of these equations for predicting incident HF in a non-US population.

Main Methods:

• Retrospective cohort study of 1,394,411 Israeli residents (2008-2018).
• Utilized electronic health records to extract demographics and risk factors (BMI, BP, glucose, medications, smoking).
• Applied PCP-HF equations to estimate 5- and 10-year HF risk and assessed model discrimination (C-statistic).

Main Results:

• The PCP-HF model demonstrated excellent discrimination for 5-year (C-statistic=0.82) and 10-year (C-statistic=0.84) incident HF prediction.
• Incident HF occurred in 1.2% of participants over 5 years and 4.5% over 10 years.
• The model performed well across a large, diverse patient population.

Conclusions:

• The PCP-HF risk prediction equations are accurate and reliable for estimating 5- and 10-year HF risk in a non-US population.
• These validated equations can be effectively used with routinely collected clinical data for HF risk stratification.
• The findings support the broader application of PCP-HF for global heart failure prevention efforts.